staph infections of sweat glands and glabrous skin Flashcards
whay is the disease caused of the sweat glands linked w/ staph aureus
hiradenitis suppurativa
alt name for hiradenitis suppurativa
acne inversa even though its not a form of acne and responds to some acne rx
what causes hiradenitis suppurativa
unknown risk factors -genetic -obesity -smoking -hormones
what suggests a hormonal link to hiradenitis suppurativa
usually presents after puberty and worsens around menstruation in woman
what is hiradenitis suppurativa
condition characterized by boils (abscesses) of the apocrine glands d/2/ comedone occlusion and bacterial buildup
hiradenitis suppurativa sx
multiple painful boils
site
-armpits. genitals, anus, neck
boils can ooze pus and have foul smell
hyperpigmentation of affected areas
dg of hiradenitis suppurativa
phyisical exam
history
blood test
culture
hiradenitis suppurativa rx
topical/ oral antibiotics risk factor reductio m retinoids anti androgen therapy immunosuppressants
- weight loss
-ceas smoking
-proper hygiene
=avoid trauma to characteristic sites
-
name of staph disease of glabrous skin
Staphylococcal scalded skin syndrome (SSSS)
define (SSSS)
disease charac by red blisters resmebling a scald
PP of (SSSS)
staph aureus releases epidermolytic toxin A and
epidermolytic toxin B
toxins break up desmosomes and skin cells are unable to adhere to each other
what molecule in desmosomes is attacked in SSSS
desmoglein 1
pop at risk of SSSS
children under 5
immonucompromised
renaal failure pt
- toxins are cleared by the kidneys
why are neonates MOST at risk
they lack specific immunity to the staph epidermolytic toxins
immature renal system
progression of SSSS
1st: fever and erythema a
2nd: after 24hrs: fluid filled blisters
3rd: rupture leaving scaleded like skin behind
SSSS lesion described
tissue paper wrinkled skin
red moist tender skin on blister rupture
sites
- begins at armpits and groin
- orifices: nose anad ears
- spreads to arms and legs
SSSS dg
positive nikolsky
tzanck smear
biopsy- shows intradermal cleavage
culture
What is a tzanck smear
scraping of an ulcer base to look for Tzanck cells
what are tzanck cells
degenerated epithelial call from keratin later thays disconnected from other cells . present as hyperchromatic epithelial cells lying free in the vesicular space d/2 acantholysis
what is acantholysis
loss of intercellular connections, such as desmosomes, resulting in loss of cohesion between keratinocytes, seen in diseases
what diseases are tzanck cells seen
SSSS
pemphigus vulgaris (NOT BULLOUS)
Chicken pox
herpes zoster
rx of SSSS
IV flucloxacillin
vancomycin if caused by MRSA
why is flucloxacillin used in SSSS
its penicillinase resistant
suppurative rx of SSSS
petroleium jelly to moisturise skin
maintail water electrolyte balance
paracetomol for pain and fever
incuvation for neonates
